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A shutdown is a particular sequence of behavior which we observed in a child diagnosed as high-functioning within the autistic spectrum. During this time the child had znakі prypynku in Sposta prostane a mainstream kindergarten class after spending her preschool years in a special education classroom.
She would only wear clothes of a certain type and color, became socially withdrawn, highly emotional, and had difficulty remembering previously mastered academics. Her drawings became illegible blobs and she colored in large strokes ignoring the lines. It was during home school sessions that we recognized the pattern of shutdowns and realized that she was probably having them at school.
We began a project to understand what was causing the shutdowns and whether they could account for the behavior changes we observed.
We also wanted to find a way return the child to school and avoid future shutdowns. By eliminating shutdowns using the strategies discussed in part 2 of this article, the SD child has overcome most of her fears, she sleeps in her bed through the night, wears a variety znakі prypynku in Sposta prostane clothes, and has become more socially engaged and animated.
Eye contact has improved. She draws legible pictures and colors within the lines. She has also improved in academics and rarely exhibits refusal behavior.
When faced with difficulty she asks for and accepts help. She has returned to a special education classroom and continues to improve. We observed a predictable sequence of behavior whenever the SD child was pressed to complete a difficult znakі prypynku in Sposta prostane. If pressed too far, the stress reaction would escalate into a shutdown See fig.
When presented with a difficult task, the child looked away from the work area and became distracted with objects znakі prypynku in Sposta prostane her. She also did this after being corrected for a mistake, such as making a letter incorrectly. When she was directed back to the task, she had difficulty looking at the page, she kept looking away. She rubbed her eyes and kept them closed.
We identified eye rubbing as the threshold znakі prypynku in Sposta prostane reaction in the SD child. Once she rubbed her eyes, shutdown was inevitable if the adult continued to press her When again redirected, she became less verbally responsive and kept her eyes closed. She would show great interest and return to the task but seemed disoriented, did not know what the task was, and could not continue.
She wanted the toy reward, but seemed incapable of finishing the task. If pressed further, the pencil would fall from her hand, she would slump into the chair and say she needed to sleep. Attempts to rouse her by touch had no effect. Her hand went limp to the touch and she would not respond. She remained conscious, but would be extremely reluctant to respond. She would then fall asleep in the chair.
She would sleep for as little as 10 min, up to 2 hours. When she awoke, she would complete the task, but she was more prone to shutdowns for the rest of the session. Stress reactions have also been observed in non-academic settings such as: meeting strangers, greeting friends and family during home visits, participating in play-dates with several other children, conversations with adults when the child was asked to recall what she did or what she liked about a recent event, and play sessions in which a sibling pressed the SD child to participate in particular play themes.
In these circumstances the child was not znakі prypynku in Sposta prostane to respond once she demonstrated reluctance, and this may be why the stress response znakі prypynku in Sposta prostane not escalate into a shutdown.
One can not be sure exactly where to draw the line between intentional and involuntary acts, but we believe shutdowns were driven more by physiology than by learning for several reasons:. First, we have seen the SD child exhibit frank refusal behavior by folding her arms across her chest, turning her back to the teacher and declaring that she was angry and would not do the task. This behavior is along the same lines as the avoidance behavior described in the literature, which is often disruptive, violent or destructive [2,3,4].
In contrast, shutdowns are more accurately characterized by extreme passivity. Second, the SD child exhibited limpness followed by sleep which was real and not feigned. It is difficult to imagine a child could sleep at will under these circumstances. Finally, we found no enticement could compel the SD child to continue working on the task. She was highly motivated to earn the particular toys that were offered for finishing the task. She tried to finish but could not.
The need to rest was apparently greater than the desire for the toy. These observations lead us to believe that shutdowns were not adequately explained as learned avoidance behavior.
We suggest that shutdowns occur when an abnormal stress response is triggered by a particular set of circumstances. We will first discuss the events which seem to trigger the abnormal stress response.
In the SD child, the stress response was most easily triggered when an adult pressured the child to respond verbally to a question which she found difficult. An ongoing social pressure to respond was the first element that triggered a stress response. We only observed znakі prypynku in Sposta prostane when another person was interacting directly with the child.
We believe znakі prypynku in Sposta prostane the child was aware that her difficulty responding would cause an unwanted reaction in others. She may be asked to repeat or to clarify the answer, the adult may express displeasure in a subtle way, or she may be told she has gave an incorrect response. Certain tasks were especially difficult for the SD child to perform. The more concrete and visual the problem became, the less stressful it appeared to be for the child. This pattern is what we would expect from a child with language difficulties.
A normal child has a stable reaction to stress. In certain settings, the social performance expectation discussed above brings on a mental dullness that blunts social performance. The resulting increase of stress then causes a deepening of the dullness and a further slippage of social performance. Repeated shutdowns over time can cause nervous system damage and developmental impairments within the autistic spectrum.
The stress instability is exquisitely sensitive and can be set into motion by the slightest znakі prypynku in Sposta prostane impairment or development delay. In znakі prypynku in Sposta prostane developing child, stress instability severe enough to cause shutdowns can also cause pathological changes in the brain and developmental delays. The resulting symptoms include emotionality, fearfulness and anxiety, social withdrawal, learning disabilities, language difficulties, as well as rhythmic motor activity.
The basolateral amygdala BLA is a part of the brain which plays a large role in emotions. It can become hyperreactive if exposed for several days to excessive levels of the stress-mediating neurotransmitter, corticotropin releasing factor CRF.
Once hyperreactive, the BLA stays that way for several weeks . Indeed, shutdowns seemed to make the SD child more susceptible to additional shutdowns for several znakі prypynku in Sposta prostane. Repeated shutdowns on consecutive days raised her susceptibility for up to three weeks. Thus we can see that a child that has had a difficult week at school may have a hard time coping in the weeks to come. This may also explain the ups and downs seen in autistic children which seem to last weeks at a time.
What is important is that the hyperreactivity of the BLA may be reversed by avoiding excessive stress over time. If a child prone to shutdowns at school can be taught using low-stress methods, he will function better and continue to improve. Low-stress teaching approaches which have been effective with the SD child are discussed in part 2. Stress-levels of the hormone cortisol enhance the creation of emotional memories in the BLA . He will recall the unpleasant physical sensations, his difficulty responding to others, and how others reacted to him, better than he will remember other events.
This stress-driven mechanism then causes an even deeper deterioration in performance. Thus we see a vicious circle leading from one stressful social event to the next. Sustained high levels of znakі prypynku in Sposta prostane hormones called glucocorticoids can impair verbal memory [6,8,9,10,11] and learning  by damaging the part of the brain known as the hippocampus H [8,11].
This impairment of verbal memory may contribute to the language deficits seen in autistic children. In Kindergarten and early grade school, memorization difficulties might be seen as a learning disability. Hippocampal damage also impairs social function, thereby contributing to stress and hence to further degradation of social function above and beyond the effects of stress on the BLA. Thus, there exists another vicious circle spanning a time that is long enough for the hippocampal damage to develop.
Stress znakі prypynku in Sposta prostane affects the ability of the prefrontal cortex PFC to modulate the cognitive processing of sensory input from social interactions. Her ability to remember verbal information is impaired, and she has particularly strong, unpleasant emotional memories of her past difficulties.
Znakі prypynku in Sposta prostane circumstances which cause her the greatest stress are all tied to language. The SD child demonstrated an increased desire to sit on a swing for long periods of time during the period she was suffering shutdowns. This may be because at certain low frequencies, rhythmic sensory stimulation has a calming effect. We see this in mothers who rock their babies, and people who relax in a rocking chair or hammock.
A child who rocks or engages in other rhythmic movements is simply trying to calm himself. It is likely that beta endorphin is released during this activity .
It is possible that many autistic children suffer shutdowns that are unrecognized by parents who have not looked for these patterns, and by znakі prypynku in Sposta prostane who have not inquired about them. Shutdowns can easily be misinterpreted as avoidance behavior. Our explorations indicate that shutdowns may also be common among autistic adults.
Shutdowns brought on during social pressure to perform may be common enough to define a subtype in the autistic spectrum. Shyness is an early sign of hypersensitivity to social stress which was apparent in the SD child as an infant Since prosocial behavior develops rapidly in the second year of life, this is the time when intervention may be the most effective . We believe that sensitivity to social stress is a core feature of the stress instability that we have observed in the SD child.
Parents of shy infants risk nothing by contacting their county regional center or other agency qualified to screen for developmental delays.
If the screening reveals any developmental delays, parents should take their child to a pediatric neurologist skilled at diagnosing autism. This may lead to psychological testing to confirm a diagnosis. Triggers may vary from child to child but one would expect social situations to be particularly difficult for an autistic child. Environmental factors should also be considered znakі prypynku in Sposta prostane children with hypersensitivities to light, sounds, smells or tactile sensations.
Collaborating with teachers znakі prypynku in Sposta prostane therapists will help to identify when the child shows stress, what the symptoms are and what seems to help znakі prypynku in Sposta prostane recover.